Mom is in a skilled nursing center in Michigan and on Medicaid. She has been on Medicaid for more than five years. She receives Social Security and pays all but $60 a month to her care. She has no other bills so her account accrues the $60 every month and is now over the limit by $500. Her son, my husband, is her DPA. I do all of her laundry and take her to her appointments and handle her paperwork. We need to get her balance below $2000 and keep it there. Any thoughts?

Why isn't she spending her $60? Doesn't she have her hair done, order a pizza once in a while, buy cards to send to the grandkids? The way to keep the balance under the limit, it seems to me, is to encourage her to spend $10 to $15 on herself each week. My mom's nh took residents who wanted to go to Walmart once a month. Mom bought a blouse or a little plant or lipstick or nail polish or warm slippers, etc. etc. She had her hair done regularly at the on-site beauty parlor. My sister watched her balance and never let it get too high. If it approached going over the limit we discussed what to buy mom with the excess. Seems to me it was usually shoes or wardrobe items.

How can you get it under the limit now? As long as the money is spent on Mom, just about anything goes. Does she have a pre-paid funeral arrangement? Would it be good to increase that a bit? Would she like a more deluxe wheelchair than the facility provides? How about a wardrobe update? (Maybe replace all the things that the laundry has shrunk with nice pre-shrunk items.) Get a nice birdfeeding station to put outside her window.
Helpful Answer (25)
Reply to jeannegibbs

Consider purchasing some kind of a prepaid funeral plan. Start with the $2,500 in her account now and then see if you can add the $60 each month to the account.
Helpful Answer (15)
Reply to AlfredR

Yes, its a personal needs account (PNA). If you buy her clothes, take in the receipt and get reimbursed. She likes certain toiletries, food, candy. Buy it and get reimbursed. New shoes, housecoat. I would start thinking of things before Medicaid does their audit.
Helpful Answer (11)
Reply to JoAnn29

$2 a day... that's a newspaper and a cup of reasonably nice coffee, isn't it? I like all of the ideas for little treats - encourage your mother to pamper herself :)

If her dementia makes her unable to pick anything out for herself at all, it is still fine to spend her money on things for her. And they can be as fun and frivolous as you think she will like.
Helpful Answer (9)
Reply to Countrymouse
jeannegibbs May 29, 2018
Um, no, CM, sadly $2 will not buy both coffee and a newspaper. But a newspaper subscription is a good thing to spend some money on. And a fancy coffee once in a while would appeal to many. Or a milkshake (not daily, of course).
Especially not if they are on Medicaid.

Buy special treats for your mom, get her new clothes, new teeth, glasses or whatever she needs.

Do not pay more to the facility, use if for mom.
Helpful Answer (9)
Reply to Isthisrealyreal

New eyeglasses? A housecoat? Anything that may brighten her day and outlook. Then do something nice for her monthly. A magazine subscription?
Helpful Answer (8)
Reply to gladimhere

Obviously we all could spend that money quickly. I believe the OP was asking what the excess can be spent on legally without Medicaid getting their shorts in a bunch. It was a legit question since Medicaid is watching every penny spent out of moms accounts and the yearly renewal catches all balances and large expenditures. As long as receipts are kept just in case, good advice has been given.
Helpful Answer (8)
Reply to rocketjcat

shakingdustoff, I know you were speaking toungue in cheek, but please don't give tax advice. You can't send some one a gift and "write it off your taxes"
Helpful Answer (5)
Reply to DafnaS

Get her hair done each month. Since she has so much excess built up right now the new wardrobe sounds like an excellent idea. How about getting her flowers occasionally. My Mom's home charges a monthly fee for TV in the room. Would she enjoy her own TV? Does she have room for a lift chair/comfortable chair in her room? Possibly get that for her.
Helpful Answer (4)
Reply to Nancynurse

After you’ve spent what money you can on her (all of the ideas given so far are excellent), if her account still goes over the limit, why not talk with the SNF. Could there be a combination pay where the excess goes to them and the rest is made up with Medicare/Medicaid? Or, if the things you do for your mother put you in a financial bind, I’ve seen discussions in this group about paying/reimbursing yourself as a care-giver. I don’t know how that works while the person you are caring for is receiving Medicaid, but I’m sure there are experts who could help. Perhaps st the SNF, or your area agency on aging, or, if all else fails, an attorney. Wishing you the best as you help provide this care for your mother. It is s complex and complicated journey.
Helpful Answer (2)
Reply to MelissaPA2AZ

See All Answers
Subscribe to
Our Newsletter